The Problem: Ankle Instability

After more than a year with ankle sprains, knee, and now hip pain, I stopped running in August 2013. I had never been a runner with on-going or repeat injuries, careful to warm-up before hard runs and stretch before every run. So I was determined to figure out what was root of all my problems.

Dr. Knee had not been as helpful as I had wished, so I thought to try finding another doctor: someone who focused on Sports Medicine or ankles.

So I found an orthopedic surgeon who specialized in ankles (one of the four in town). He ran another set of X-rays on my ankles in twisted positions. Again, nothing unusual showed up, just like my other x-rays and MRI (but he did find a bone spur in my arch where i had torn my plantar fascia). He looked at my feet for about five minutes, trying to find my pain and asking me to stand one leg, etc. Then he said, “Well, you will need surgery if you ever want to run again, or wear an expensive motion-limiting ankle brace which may or may not work.” In my mind my response was “$$&;@@#%^?!!!! You must be mistaken.” I did discuss it with him for a few more minutes, desperately going through every scenario with the Dr. in which I would not need surgery. In the end, he said that I had basically stretched my lateral ankle ligaments and there was no way I could get them to be “stretched back” and my ankle was unstable. Well yeah its unstable, I keep rolling it. And that if I wanted the surgery, I’d have to see another surgeon because, oh by the way, he was retiring.

Not happy with my answer, I left his office determined not to have surgery. I would try not running at all and doing physical therapy for at least 6 months, and go from there.

As it happened, my dad (the avid runner) mentioned my issues to his chiropractor, who also specialized in Sports Medicine (and was the team doctor for a couple of local colleges and the arena football team). My dad described my problems to him, and immediately he told him I had ankle instability. He asked if I would come in to see him and he would look at my ankle and get me started on some therapy. He also did not like the idea of jumping to surgery. So, I thought, why not?

I learned from him that chronic ankle instability, was truly a clinical term. And that there was potential to gain some of my “tightness” in the ligaments. This is my understanding of what occurred from the original ankle sprain:

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While rolling my ankle off of an 8″ curb, the lateral ligaments of the ankle were stretched out and had small tears made in them. The tears healed, but the ligament did not retract to its original size and remained lengthened. Thus, creating a lax ligament that was not able to perform its function of holding that ankle joint in place.

As a result, the other muscles and ligaments in my foot, ankle, even lower leg, had to work harder to compensate for the additional movement in the ankle joint. If those muscles and tendons became over-worked, then my knee and my upper leg and my hip became out of alignment slightly and those muscles and tendons tried to compensate for it as well. See how the problem spreads?

The goal with the chiropractor was to strengthen the muscles around the ankle and get rid of some of the scar tissue. So physical therapy began, with minor exercises to improve my range on motion. For two weeks, it hurt and nothing improved.

Then the chiropractor went to a seminar on ankle injuries. Next time I saw him, he took hold of my feet and felt all the bones and their placements. Most of the bones in my left were out of alignment (comparing it to my right). He went to work to set everything back. Yes, he literally popped my talus, my arch, my toes, even my knee, and to my shock my lower back. It hurt some and throbbed as usual afterwards. However, the next day, I had no pain in my ankle, knee, or hip!! It was a miracle.

I went to the chiropractor one or two days a week, doing the physical therapy and getting realigned. If I didn’t do anything too strenuous, the ankle stayed in place for about a week. I walked for exercise during this time, and went from 20 minutes to 50 minutes before rolling the ankle. It was a huge improvement. However, despite wearing an ankle brace, I”d still roll my ankle walking on a flat surface. By January of 2014, five months after seeing the first surgeon and doing physical therapy, I thought it was about time to get a second opinion and explore my options.

The Injury: Back Story

Well I had every intention of starting this blog on a new training regime prepared to share workouts and dinner recipes. But the ankle sprain that I was waiting and re-waiting to heal and get better never quite did. So I’m afraid I will have to start this running blog in a cast, unable to run. And trust me, this is progress.

I sprained my ankle (rolled my left ankle outward and scrapped the ground with it) during a 5k, in May 2012. Yes, I am now writing this in February 2014. It has taken almost 2 years to identify the problem and determine a solution. I really don’t want a single runner out there having to go through that. So here’s to learning from someone else’s experience.

After spraining my left ankle about 1 minute into the race (and finishing it of course like a dunce), I stayed away from ankle rolled outwardrunning about 3 weeks. I did not see a doctor. I began running with or without a brace, and upon the start of some interval training, felt my arch collapse. I ran sparingly and raced twice until August 2012. By this time, my knee was killing me, and if I ran in a way that helped my knee, my ankle was killing me. It was time to see a doctor.

I’d never gone to see a doc for a sports related injury, so I went to my General Practitioner and had them recommend someone: it was a surgeon that specialized in knee and shoulder surgery and had a background in Sports Medicine. I’ll refer to him as Dr. Knee. Dr. Knee diagnosed me with plantar fasciitis, achelies tendonitis, shin splints, and a small stress fracture in my tibia. 6 weeks off from running. Then rehab. Rehab helped a lot. Started running, and barely made it for the Army Ten Miler in late October. I did so well, not only did I finish, I averaged about 7:30min/mile pace. Overly ambitious, I ran two days afterwards and bam, pain in knee and ankle.

The weeks and months that followed were nothing but a series of cycles between being injured and running a little. I just kept getting hurt and spraining that ankle. My dad (an avid runner for over 40 years) suggested that my new hip pain and knee pain, were all derived from my ankle. I went back to see Dr. Knee, who did xrays and an MRI on my knee, only to find no issues. Then I asked him to consider my ankle as a source of the knee pain, and I had an ankle MRI end of July. Again, he said there was nothing to be found. Slightly disheartened, I began running again, slowly.

Less than a week later August 3 of 2013, I sprained my ankle for the 7th time. I stopped running and decided not to run again until I figured things out.